摘要
目的探讨超声二维斑点追踪成像分层应变技术及跨壁阶差评价高血压患者左心室各层心肌功能改变的临床应用价值。方法选取高血压不合并肾功能不全者35例作为A组,高血压合并肾功能不全者25例作为B组,同时选取健康志愿者40例作为对照组。应用二维斑点追踪技术获得左室各层收缩期峰值纵向应变(LPS):内层心肌整体纵向应变(LPSEndo)、中层心肌整体纵向应变(LPSMid)、外层心肌整体纵向应变(LPSEpi),计算心肌应变各层间的跨壁阶差(ΔLS)及跨壁阶差百分比(ΔLS%)等指标进行分析。结果各组组内左心室心肌各层LPS均存在梯度特征:LPSEndo>LPSMid>LPSEpi。各组组内LPSEndo与LPSMid比较、LPSEndo与LPSEpi比较,差异均有统计学意义(P<0.05);A组、对照组组内LPSMid与LPSEpi比较,差异均有统计学意义(P<0.05)。与对照组比较,A组LPSEndo减低,B组LPSEndo、LPSMid、LPSEpi减低,差异均有统计学意义(P<0.05);与A组比较,B组LPSEndo、LPSMid、LPSEpi减低,差异均有统计学意义(P<0.05)。三组间ΔLS相互比较,差异均无统计学意义(P>0.05)。与对照组比较,A组ΔLS%Endo-Mid增高,B组ΔLS%Endo-Mid、ΔLS%Mid-Epi增高,差异均有统计学意义(P<0.05)。与A组比较,B组ΔLS%Endo-Mid、ΔLS%Mid-Epi增高,差异均有统计学意义(P<0.05)。结论分层应变技术可定量评价高血压患者左心室心肌各层收缩功能的改变,ΔLS%可能较ΔLS在反映左室心肌各层收缩功能受损方面具有更好的敏感性,可为左心室收缩功能评价提供更多的参考依据。
Objective To investigate the value of ultrasonic two-dimensional speckle tracking imaging(2D-STI) layer-specific strain and transmural gradient in evaluating the changes of hypertensive patients′ left ventricular three layers myocardial function. Methods Thirty-five hypertensive patients without renal insufficiency were selected as group A, and 25 hypertensive patients with renal insufficiency as group B. For comparison, 40 healthy volunteers were gathered as control group. Then, the systolic peak longitudinal strain of the left ventricle(LPS), endocardium(LPSEndo), mid-cardium(LPSMid) and epicardium(LPSEpi) were collected.After that, features of transmural gradient(ΔLS) and its percentage(ΔLS%) were analyzed. Results For each group, gradient features exist in each layer of left ventricular myocardium: LPSEndo>LPSMid>LPSEpi. For each group, the differences between LPSEndo and LPSMid, and that between LPSEndo and LPSEpi were both statistically significant(P<0.05). When it came to the differences between LPSMid and LPSEpi, those of group A and control group were both statistically significant(P<0.05). Compared with control group, the LPSEndo of group A, and LPSEndo, LPSMid and LPSEpi of group B declined, all the differences were statistically significant (P<0.05). Compared with group A, LPSEndo, LPSMid and LPSEpi of group B declined, the differences were statistically significant (all P<0.05). For ΔLS′s differences among all three groups, there was no statistical significance(P>0.05). Compared with control group, the ΔLS%Endo-Mid of group A rised, and the ΔLS%Endo-Mid,ΔLS%Mid-Epi of group B rised, the differences were statistically siginificant(all P<0.05). Compared with group A, the ΔLS%Endo-Mid,ΔLS%Mid-Epi of group B rised, the differences were statistically siginificant(all P<0.05). Conclusions The layer-specific strain technique can quantitatively evaluate the changes of systolic function of the left ventricular myocardium in hypertensive patients.ΔLS% may have better sensitivity than ΔLS in decti
作者
吕诗佳
袁建军
朱好辉
张喜君
陈纪昀
李杨
李帅
吴铭
魏常华
Lyu Shijia;Yuan Jianjun;Zhu Haohui;Zhang Xijun;Chen Jiyun;Li Yang;Li Shuai;Wu Ming;Wei Changhua(Department of Ultrasonography, Henan Provincial People′s Hospital of Henan University, Zhengzhou 450003, China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2019年第5期392-396,共5页
Chinese Journal of Ultrasonography
基金
河南省2017年度医学科技攻关计划(201702189)
河南省2016年度医学科技攻关计划(201602247).
关键词
超声心动描记术
高血压
心室功能
左
分层应变
跨壁阶差
Echocardiography
Hypertension
Ventricular function, left
Layer-specific strain
Transmural gradient
